A crucial fact about American medicine goes largely ignored, even by doctors. Dollar for dollar, more people will gain years of healthy lifespan from prevention than from drugs or surgery. We don’t tend to think that prevention costs money. Once you learn that cigarettes cause lung cancer, you can decide not to smoke. The choice is free if you were a non-smoker to begin with. If you get up off the couch and start a brisk walking program to help prevent heart disease, that choice also doesn’t cost a penny.

What isn’t free, however, is getting information out there. Poor and less educated Americans are known to have a higher prevalence of major lifestyle disorders like heart disease, obesity, hypertension, and type 2 diabetes. The reverse is also true: better lifestyle choices are made by the affluent and well educated.

You can’t prevent what you don’t know about. That makes it essential that we keep funding the most dollar-wise education for physicians so that young residents can go on to spearhead prevention programs. America cannot continue to rely on a reactionary stance of simply treating health issues. It must refocus its efforts and investments in prevention. The surgery to treat a lung cancer patient is highly unlikely to succeed and will be very expensive. Informing a middle-school classroom about the risks of smoking potentially saves lives at a fraction of the cost.

Although most people still view being sick in terms of germs, catching a cold, and getting a flu shot, the question of who gets sick and who stays well is far more complex. Everyone is exposed to thousands of microbes a day, and some of these are disease-causing pathogens. But we have immunity to a wide range of pathogens, and although sickness is fended off by the cells of the immune system, staying well involves the whole person.

There is a medical concept known as “control by the host,” which focuses on how much of staying well is an internal process that calls upon both mind and body. The invisible roots of lifelong wellness turn out to be surprising. For example, researchers at the University of Texas Medical School looked at mortality rates among a group of men and women who had received open heart surgery, including heart bypass and replacement of the aortic valve. If you take the routine medical approach, the reason someone dies six months after open heart surgery while someone else doesn’t must come down to a physical difference. But the team headed by Dr. Thomas Oxman took an unorthodox approach. They asked these patients two questions about their social situation: Do you participate regularly in organized social groups? Do you draw strength and comfort from your religion or spiritual faith?

In 1952 a young British physician made a mistake. It was a mistake that was to bring short-lived scientific glory to Dr. Albert Mason. Mason tried to treat a fifteen-year-old boy’s warts using hypnosis. Mason and other doctors had successfully used hypnosis to get rid of warts, but this was an especially tough case. The boy’s leathery skin looked more like an elephant’s hide than a human’s, except for his chest, which had normal skin.

Mason’s first hypnosis session focused on one arm. When the boy was in a hypnotic trance, Mason told him that the skin on that arm would heal and turn into healthy, pink skin. When the boy came back a week later, Mason was gratified to see that the arm looked healthy. But when Mason brought the boy to the referring surgeon, who had unsuccessfully tried to help the boy with skin grafts, he learned that he had made a medical error. The surgeon’s eyes were wide with astonishment when he saw the boy’s arm. It was then that he told Mason that the boy was suffering, not from warts, but from a lethal genetic disease called congenital ichthyosis. By reversing the symptoms using “only” the power of the mind, Mason and the boy had accomplished what had until that time been considered impossible. Mason continued the hypnosis sessions, with the stunning result that most of the boy’s skin came to look like the healthy, pink arm after the first hypnosis session. The boy, who had been mercilessly teased in school because of his grotesque-looking skin, went on to lead a normal life.

Is everyone around you coming down with colds and flu? And those nasty respiratory infections that linger so much longer than anyone expects? That’s February. A volatile month, a gauntlet we run to make it to spring. Whether you’ve got kids in school, like little Petri dishes scooting around, or you’re hopping on an airplane, or shoulder to shoulder on the subway, unless you live in a bubble, you are vulnerable.

What can you do to prevent colds and flu?

Inflammation has always been a medical mystery, but now it has become an enemy of long-term health. On the one hand, when your skin turns red, swollen, and painful after you burn yourself, which triggers acute inflammation, the response is normal and beneficial. Extra red blood cells, immune cells, and anti-oxidants are rushing to the wounded site to heal it. But carried too far, inflammation can be fatal, as when someone is too burned to recover.

Only in the past few decades has it dawned that low-level chronic inflammation, which usually goes completely unnoticed plays a part in many lifestyle disorders such as hypertension, heart disease, cancer, and Alzheimer’s. Chemicals known as inflammation markers can enter the bloodstream in various ways: from the intestinal tract (so-called leaky gut), as a reaction to infection, or through the action of the immune system in other internal ways. The slow drip, drip of inflammatory markers can take years to create major impairment, which means that each person must tailor his lifestyle to counter them.

Diet alone isn’t enough to keep chronic low-level inflammation at bay, but it’s a good start. By adopting an anti-inflammation diet, you aim at two positive results: keeping the micro-organisms in your intestines healthy and flourishing, and thereby preventing the seepage of toxic chemicals into the bloodstream. There is also the indirect benefit that a healthy digestive system sends signals of wellbeing along the vagus nerve to the heart and brain.

When the average person goes to the doctor, shows up at the ER, or enters the hospital, the possibility of controlling what happens next is minimal. We put ourselves in the hands of the medical machine, which in reality rests upon individual people—doctors, nurses, physician’s assistants, and so on. Human behavior involves lapses and mistakes, and these get magnified in medical care, where misreading a patient’s chart or failing to notice a specific symptom can be a matter of life and death. The riskiness of high-tech medicine like gene therapy and toxic cancer treatments is dramatically increased because there is a wider range of mistakes the more complex any treatment is. To be fair, doctors do their utmost to save patients who would have been left to die a generation ago, but they are successful only a percentage of the time.

Risk and mistakes go together, but the general public has limited knowledge of the disturbing facts:

• Medical errors are estimated to cause up to 440,000 deaths per year in U.S. hospitals alone. It is widely believed that this figure could be grossly inaccurate, because countless mistakes go unreported—death reports offer only the immediate cause, and many doctors band together to protect the reputation of their profession.

• The total direct expense of “adverse events,” as medical mistakes are known, is estimated at hundreds of billions of dollars annually.

• Indirect expenses such as lost economic productivity from premature death and unnecessary illness exceeds $1 trillion per year.

Statistics barely touch upon the fear involved when any patient thinks about being at the wrong end of a medical mistake. What the patient is all too aware of is the doctor visit that goes by in the blink of an eye. A 2007 analysis of optimal primary-care visits found that they last 16 minutes on average. From 1 to 5 minutes is spent discussing each topic that’s raised. This figure is at the high end of estimates, given that according to other studies, the actual face-to-face time spent with a doctor or other health-care provider comes down to 7 minutes on average. Doctors place the primary blame on increasing demands for them to fill out medical reports and detailed insurance claims. Patients tend to believe that doctors want to cram in as many paying customers as they can, or simply that the patient as a person doesn’t matter very much.

Many experts have written about the problems healthcare faces. The Institute for Healthcare Improvement has codified their approach to a solution in the Triple Aim, which seeks to curb cost and improve the patient care experience and health of populations. Healthcare futurists talk about solutions in the form of personalized medicine, nanotechnology, remote/virtual care, concierge care, and more.

But there is one problem that no healthcare pundit is talking about today, yet it lives at the very heart of healthcare. Solving this problem is the key to ushering in a cutting-edge scientific era of Enlightened Medicine that will bring joy and healing to the practice of medicine.

The core problem in healthcare

The core problem in healthcare is that the medical science we follow is remarkably outdated and incomplete. For decades, we've been taught that the human body is a machine, made up of little pieces called atoms. We believed this starting from grade school through college and medical or nursing school. Our teachers said, “When you put a bunch of atoms together, you get a molecule, then macromolecules, then eventually cells, organs, and finally a human being.” We were told this repeatedly in textbooks, lectures, and laboratories until it hardened as part of our scientific belief system.

The holes in this belief system were not discussed. Life, emotion, thought, desire, joy, purpose, and meaning were mostly ignored, but to the rare persistent questioner these were explained away as mere combinations of microscopic ball-like atoms bumping into each other. Was there science to back up that claim? Sure there was. But like all scientific conclusions, these interpretations were based on a fundamental philosophical assumption that we weren’t told about; namely, that the world is ultimately a physical thing and we are physical things.